PURPOSE: Tubularized incised plate (TIP) urethroplasty, with good results for hypospadias, has recently been reported. We analysed the surgical outcomes according to the site of the urethral opening in children with hypospadias, using TIP urethroplasty with a button hole flap. MATERIALS AND METHODS: Between August 1996 and May 2004, 40 patients with hypospadias were primarily corrected using TIP urethroplasty, with both a conventional and a button hole flap by one surgeon. The medical records of all patients; the levels of meatus, age at surgery, surgical outcomes, complications, methods of second operation and their outcomes, were reviewed retrospectively. The preoperative types of hypospadias were glanular, coronal, anterior penile, mid-shaft, posterior penile and penoscrotal in 8, 7, 9, 6, 4 and 6 boys, respectively. RESULTS: The mean age of the patients was 8.2 years. The overall success rate was 75.0% (30/40). The success rates, according to the type of hypospadias, were 87.5% (7/8), 75.0% (6/8), 77.8% (7/9), 66.7% (4/6), 75.0% (3/4) and 50.0% (3/6) in the glanular, coronal, anterior penile, mid-shaft, posterior penile and penoscrotal types, respectively. Postoperative penile distortion was seen in 37.5 (3/8) and 6.2% (2/32) of the conventional and button hole flap groups, respectively. The incidence of postoperative penile distortion in the button hole flap group was significantly lower than in the conventional group (p=0.046). Complications occurred in eleven patients, including urethrocutaneous fistula (9/11), urethral stricture (2/11) and depressed meatus (1/11). The patients with complications were treated with fistula repair, urethral dilatation and repeated TIP urethroplasty. CONCLUSIONS: Our surgical experiences and outcomes show a high success rate, low complication rate and excellent cosmetic appearance for all types of hypospadias. The incidence of postoperative penile distortion was significantly low. Therefore, TIP urethroplasty, with a button hole flap, can be used as a first choice for all types of hypospadias.
Child ; Dilatation ; Female ; Fistula ; Humans ; Hypospadias* ; Incidence ; Male ; Medical Records ; Retrospective Studies ; Urethra ; Urethral Stricture

Forty five cases of adult tibial shaft fractures were treated with flexible intramedullary nails under image intensifier at the department of orthopaedic surgery, Capital Armed Forces General Hospital during between April 1986 to July 1988. The results were summarized as follows: 1. 45 cases were all male, the average age was 24.3 years and the most common cause of fractures was sports injury(20 cases) and the second most common cause was traffic accident(18 cases). 2. 11 cases out of 45 cases were open fracture and 34 cases were closed fracture. Eight cases of open fraeture were grade I and three cases were grade II. Twenty eight cases were comminuted fracture. The most common level of the fracture was middle third of the tibial shaft. 3. Average interval from injury to Ender nailing was 13.5 days and the mean duration of permission to full weight bearing was 9.2 weeks. 4. Out of 2 cases of delayed union, the average time of clinical bone union was 9.7 weeks and that of roentgenological bone union was 14 weeks. 5. 11 cases of complication were noted among the 45 cases of tibial shaft fracture which were treated by PGP nailing such as angulation, rotation, ankle joint stiffness, delayed union, shortening, and soft tissue infection. 6. PGP nailing is considered to be a valuable method in treating tibial shaft fracture because of their relative ease of nailing, allowing early weight bearing and decreased complication.
Adult ; Ankle Joint ; Arm ; Fractures, Closed ; Fractures, Comminuted ; Fractures, Open ; Hospitals, General ; Humans ; Male ; Methods ; Soft Tissue Infections ; Sports ; Tibial Fractures ; Weight-Bearing

PURPOSE: To evaluate clinical features and the effect of parathyroid hormone (PTH) on treatment outcomes of patients with pelvic insufficiency fractures. MATERIALS AND METHODS: Fifteen patients diagnosed with pelvic insufficiency fractures were evaluated retrospectively. All patients had osteoporosis with mean lumbar T score of −3.9 (range, −3.1 to −6.4) and the mean age was 76.5 years. In all cases, simple radiography and computed tomography was used for final diagnosis; additional magnetic resonance imaging and technetium bone scans were used to confirm the diagnosis in 2 and 6 patients, respectively. Initial conservative treatment was used in all cases; treatment with PTH was applied in 5 cases. Radiological follow-up was done every 4 weeks up to 6 months and every 3 months thereafter. Symptom improvement was measured using visual analogue scale (VAS) score. RESULTS: Fractures were located: i) sacrum and pubis (9 cases), ii) isolated sacrum (4 cases) and iii) isolated pubis (2 cases). One case showed fracture displacement and pain aggravation at 4 week follow-up which was treated with percutaneous sacro-iliac fixation using cannulated screws. Duration of bone union was significantly shorter in the patients who used PTH (P<0.05). VAS scores were also lower in the group treated with PTH; however, statistical significance was not reached. CONCLUSION: In patients with osteoporosis, a pelvic insufficiency fracture should be considered if pain is experienced in the pelvic area in the absence of major trauma. While nonoperatic has been shown to be sufficient for treatment, our study shows that PTH therapy shortens treatment period and could be a favorable treatment option.
Diagnosis ; Follow-Up Studies ; Fractures, Stress* ; Humans ; Magnetic Resonance Imaging ; Osteoporosis* ; Parathyroid Hormone ; Pubic Bone ; Radiography ; Retrospective Studies ; Sacrum ; Technetium

No abstract available.
Nortriptyline* ; Pharmacokinetics*

PURPOSE: There have only been a few reports concerning the treatment of choice for overactive bladder (OAB). The aim of this study was to assess the effect of functional magnetic stimulation (FMS) in patients with an overactive bladder. MATERIALS AND METHODS: Among the demonstrable overactive bladder patients, 21 were selected. They were classified into neuropathic and idiopathic OAB according to their etiology. Voiding diary, quality of life (QOL) questionnaire and urodynamic studies were evaluated before treatment. The treatment was performed for 20 minutes, 2 times a week, for 6 weeks. All of the evaluations were repeated immediately and 3 months after treatment. The treatment outcomes were evaluated for both the neuropathic and idiopathic groups. RESULTS: The overall mean age was 44.0+/-18.6 years. After 6 weeks of treatment, the mean frequency in the idiopathic group significantly decreased from 13.0+/-2.3 to 9.7+/-2.1 times (p<0.05). The mean urgency episodes in the neuropathic and idiopathic groups decreased from 11.3+/-7.5 and 4.5+/-5.8 times to 8.5+/-6.2 and 3.0+/-4.3 times, respectively. Significant improvements were noted in the frequency, mean voided volume, maximal voided volume and QOL in the idiopathic group, which were maintained for 3 months (p<0.05). There were improvements in the symptoms and QOL in the neuropathic group also, but these were minimal. CONCLUSIONS: Our data suggest that the FMS therapy has, at least, a short-term effect on idiopathic OAB. To our knowledge this is the first report on FMS therapy for neuropathic OAB. Although its acute effect on neuropathic OAB was minimal, there was some improvement in the QOL. Therefore, in our opinion, further studies are needed to establish the long-term efficacy of FMS therapy in patients with symptoms of OAB.
Humans ; Magnetic Field Therapy* ; Quality of Life ; Surveys and Questionnaires ; Urinary Bladder ; Urinary Bladder, Overactive* ; Urodynamics

No abstract available.

The purpose of this study was to develop the antiallergic and hypoallergic fermented soybean foods without side effect. We manufactured Chungkukjang with addition of herbal (aloe, cinamon, licorice root) extract. Sensory evaluation was performed to evaluate the acceptability by the consumer. Clinical evaluation was performed with 10 atopic dermatitis (AD) patients who showed positive reaction with specific IgE and skin prick test. Cross-over study between normal Chungkukjang and Chungkukjang with aloe extract was performed. In sensory evaluation, Chungkukjang with aloe extract obtained best score overall. In clinical evaluation, 7 out of 10 AD patients showed positive reaction to soybean and 4 out of 10 AD patients showed positive reaction to normal Chungkukjang. 2 out of 10 AD patients showed positive reaction to Chungkukjang with aloe extract. In conclusion, Chungkukjang could be recommended as functional food with hypoallergic effect. As adding aloe extract to Chungkukjang, hypoallergic effect was increased.
Aloe ; Cross-Over Studies ; Dermatitis* ; Dermatitis, Atopic ; Functional Food ; Glycyrrhiza ; Humans ; Immunoglobulin E ; Skin ; Soybeans

The incidence of contralateral reflux after unilateral reimplantation in children with primary unilateral vesicoureteral reflux(VUR) is reported to be 0.8-32%. We evaluated the characteristics of contralateral reflux after endoscopic or open surgical correction of primary unilateral VUR in children. 30 children who underwent unilateral reimplantation by Paquin (25pts) and submucosal Macroplastique injection(5pts) were evaluated. The association between postoperative contralateral reflux and age, sex, ipsilateral implant side, postoperative urinary tract infection, and surgical method were evaluated. There were 18 male and 12 female patients. Initial reflux was observed in the right in 18 and 12 in left. The initial reflux grades were II, III, IV, and V in 2, 11, 14, and 3 patients, respectively. Postoperative urinary tract infection was observed in 4 patients of whom 1 had contralateral reflux. In conclusion, there was no single factor that could predict the development of contralateral reflux after unilateral correction of unilateral primary VUR. Furthermore, the fact that contralateral reflux occurred even after submucosal Macroplastique injection suggests that the method of surgery is not related to the subsequent development of contralateral reflux.
Child* ; Female ; Humans ; Incidence* ; Male ; Replantation ; Ureter ; Urinary Bladder ; Urinary Tract Infections ; Vesico-Ureteral Reflux*

Cystitis glandularis is a benign metaplastic proliferative lesion of the urinary bladder which usually occurs in the setting of chronic irritation and infection or in some cases as a congenital process. Sometimes it presents as a tumor mass-like florid lesion, grossly mimicking malignancy. We report a case of 59-year-old man with multiple mass lesions around the trigone and the neck portion, which suggested the possibility of malignancy in clinical and radiological evaluations. Final diagnosis was confirmed by transurethral resection. The surface urothelial lining was intact. The submucosa showed von Brunn's nests, cystitis glandularis and cystitis cystica in the edematous lamina propria. There were numerous glands lined by tall columnar, mucin producing epithelium without atypia, conforming to the appearance of the intestinal variant of cystitis glandularis. The cystitis glandularis may mimic a neoplasm on gross evaluation. The intestinal variant of cystitis glandularis is particularly likely to be problematic when florid.
Cystitis* ; Diagnosis ; Epithelium ; Humans ; Middle Aged ; Mucins ; Mucous Membrane ; Neck ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Captopril tablets of two different producers were tested for bioequivalence as well as therapeutic equivalence. The pharmacokinetics, the time course of plasma angiotensin-converting enzyme inhibition, and the changes of systolic and diastolic blood pressure after administration of drugs were studied. In a balanced, randomized two-way crossover design, two single doses of 50mg each of captopril were administered orally to twelve male volunteers. Peak blood levels of free captopril were observed about 0.85 hour after the dose, and practically free captopril could not be detected in blood within 8 hours. Peak free captopril levels of both compounds were almost identical(Capoten(R), 464.3ng/ml ; Capril(R), 504.6ng/ml). No statistically significant difference was identified between two compounds when area und the concentration time curve, peak level, time to peak were compared. Inhibition of plasma angiotensin-converting enzyme to blood free captopril concentration showed the hyperbolic concentration-response relationship with IC50 value of 7.4ng/ml. The area under the percent angiotensin-converting enzyme inhibition versus time curve were quite similar after administration of both drugs. The compounds were also found to be equivalent on the premise that no significant difference was detected when the time courses of systolic and diastolic blood pressure reduction were compared.
Biological Availability* ; Blood Pressure ; Captopril* ; Cross-Over Studies ; Humans ; Inhibitory Concentration 50 ; Male ; Pharmacokinetics ; Plasma* ; Tablets* ; Therapeutic Equivalency ; Volunteers